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Full text of "An address before the Medical Society of the State of North Carolina : at its first annual communication, in Raleigh, April, 1850"

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AN ADDRESS 



BEFORE 



THE MEDICAL SOCIETY OF THE STATE 



OP 



NORTH CAROL.IXA, 



AT 



ITS FIRST ANNUAL COMMUNICATION. 



IN RALEIGH, APRIL, 1850. 



By EDMUND STRUDWICK, M. D. 



RALEIGH: 

WILLIAM W. HOLDENj PRINTER. 

1850. 



ADDRESS. 



Gentlemen of the Medical Society: 

I feel a deep and proud gratification in seeing here so large 
and respectable an assemblage of Physicians. It is a favorable 
augury for our infant project. It is a bright and honorable omeu 
of future success. I bid you welcome. 

The flight of another year brings us together as an organized 
State Medical Society. Permit me to congratulate you on its 
first Annual Meeting, and to express the hope that we have met 
together with a united and honest determination to accomplish 
the purposes for which it was instituted; that we may bring to 
this work an energy commensurate with its importance — an ar- 
dor no circumstances, however discouraging, shall abate — a 
zeal that sliall never falter, until we shall have reached the de- 
sired goal liCt the fact that the medical reputation of North 
Carolina must be elevated by the success or suifer reproach by 
the failure of our undertaking, animate us with a sense of pro- 
fessional pride, which shall overcome every obstacle, conduct 
our Society to usefulness and dignity, and make it an honorable 
co-worker with the National Association, now actively engaged 
in asserting the rights of the medical profession and its high 
claims to public respect and confidence. 

When a movement so general in the profession had been made 
— when the fathers and teachers of medicine, with its able, en- 
terprising and successful practitioners, from almost every point 
of our widely extended country, had banded themselves together 
to testify their devotion to the honor and advancement of medi- 
cal Science, it was full time for us to wheel into the ranks of 
medical reform. To have lingered longer would have tarnish- 
ed our escutcheon, and have justly exposed us to reproach. 
Havmg grasped the plough, let us never look back ; let our 
watchword be '^oiitvard,^^ and by faithful and persevering ef- 
fort prove ourselves equal io the enlerprize. and worthy of the 



noble cause in which we have embarked. Let us bear constantly 
in mind the truth that our success must be the work of time, the 
result of long-continued and laborious effort. Let us then not 
be discouraged, but importunately invoke the co-operation and 
union of the medical talent of North Carolina; and if we can 
call it into exercise and bring it to bear on this subject with its 
full force and influence, a proud, and commanding success 
awaits us. 

Permit me now to make a few plain suggestions — to clear 
away some rubbish that mars and encumbers our profession — to 
clean off a place for the foundation of medical reform ; the task 
of erecting the edifice I resign to other and to abler hands. The 
idea that two of a trade cannot agree is a proverbial truth, which, 
I blush to say, is lamentably and too frequently illustrated in 
onr profession. So far as we are concerned let us strike it from 
the vocabulary of proverbs. Who has not known the best ex- 
ertions of medical skill to terminate in failure, and the want of 
success attributed by a cotemporary to a misapprehension of the 
disease and to its improper treatment ? When success rewards 
assiduity and skill it is sometimes attributed to a mere accident, or 
perhaps to some wise and potent suggestion made by the jealous 
detractor, or as resulting in spite of the treatment. Akin to this 
conduct of injustice and disparagement, is a spirit of boastful 
superiority which has no failures to record, but tells of danger- 
ous and a2:gravated cases innumerable, which yielded, as if by 
magic, to the rebukes of this wonder-working medical prowess. 
Honesty is the ornament of every vocation, and it is peculiarly 
the best policy as well as the highest privilege of the Physician ; 
and he who departs from its old-fashioned but honored maxims, 
is sure to meet with dishonor and disappointment. He who ex- 
pects to gain business or to acquire reputation by trusting to the 
meretricious tones of his own trumpet, occupies only a base and 
fancied vantao^e ground, and will sooner or later receive what he 
justly merits, the disgust of the community and the contempt 
of his fellows. Exhibitionsof disreputable medical character, I 
would fondly hope, are not of frequent occurrence; and I only 
mention them that we may place upon them the mark of disap- 
probation. 

Whenever symptoms of degeneration appear, threatening the 
vitality and purity of professional character, let us here, in a gen- 



eral consuUiitionj determine upon a bold and efficacious remedy 
— eradicate the moral seirrhus by the fearless application of the 
actual cautery ; lesser lesions or delinquencies let us correct by 
the milder measures of kindness and remonstrance; and if it 
becomes necessary to administer reproof, let the object be the re- 
formation of a friend and cotemporary, not the injury of a com- 
petitor. Let us, in a word, put on the mantle of a just, honor- 
able, and courteous brotherhood, and wear it like men faithfully 
discharging every duty it enjoins. Let the badge of medical 
profession, when rightfully worn, inspire us with mutual respect, 
command our kindest offices, ensure our best wishes, and estab- 
lish among us a spirit of reciprocal confidence and friendship. 
He who pursues the profession not simply for its proper emolu- 
ments, but with a just appreciation of the claims of humanity, 
and for the glorious privilege of doing good, must form close 
and intimate friendships with its practitioners. And this is its 
fair and legitimate tendency. And when this state of things 
does not result from long association, it shows that improper in- 
fluences, and jealousies, and ignoble rivalries have been at work, 
which must be banished from our ranks. We recognize the 
principle of fellowship and communion as peculiarly appropri- 
ate to those who endure the toils, encounter the privations, incur 
the dangers, and share in the triumphs, disappointments and 
joys incident to the prcictice of a common and noble profession. 
This is not only honorable to the profession, but is as indispen- 
sable to the advancement of medical science, as the spirit of emu- 
lation and the habit of application to study, and of close and 
correct observation. It is also necessary to a faithful record of 
medical experience to guide and instruct us. Even an author or 
a teacher, of fame and established reputation, reluctantly publish- 
es mistakes by which he has sacrificed human life. Can it then 
be expected that a physician will impart knowledge of his own 
fatal errors in the practice, unless with a full confidence which 
an assured friendship and integrity can alone inspire — that it 
will be treasured and remembered only to protect others from a 
similar catastrophe? To cement this tie of mutual confidence, is 
demanded by considerations of self-respect as well as by obliga- 
tions of duty to the public. A free interchange of personal ex- 
perience, an unreserved expression of medical opinion — now at- 
tacked, now defended — for reasons frankly avowed, not only pro- 



motes tiie pleasures of social intercourse, but results in the exten- 
sion of medical knowledge, the establishment of truth, and the 
refutation of error. 

In this connection, I may be allowed to refer to instances of 
heroism, manifested by the profession, amidst the horrors and 
dangers of the pestilence, which recently spread death and deso- 
lation over many portions of our land. I allude, of course, to 
the Cholera. The Physician in this hour of dismay, when the 
public mind quailed with fear, maintained the post of honor and 
duty — he met the pestilence which walked in darkness and 
braved the destruction "which wasteth at noonday"; inspired, 
not like the soldier on the battle-field, by the strains of martial 
music, by his leaders example and word of command ; but ani- 
mated by a disinterested sense of duty, with a confiding trust 
in the protection of Providence, he promptly obeyed the call of 
' distress, and with noiseless tread, as well in the hovels of the 
i poor and the crowded hospitals, as in the chamber of the opu- 
lent, fearlessly exposed himself to the thick and unseen shafts 
of the pestilence, to rescue his fellow-man from its remorseless 
grasp; and in the unequal conflict not unfrequently fell a vic- 
tim to his noble exertions in the cause of suffering- humanity. 
Recollections like these fill the medical heart with pride and 
sorrow. This dauntless devotion to duty challenges the admira- 
tion of mankind, and entitles the Physician to a greener laurel 
than ever decked the warrior's brow. Let us then be stimulated 
by these proud examples to be just to ourselves, and true to the 
public ; let us cherish a generous rivalry to make full and ample 
preparation for the discharge of the various duties we owe to 
the communities in which we may reside — for a summary of 
which I beg leave to refer you to our excellent Code of Ethics. 
But while we are ever mindful of the obligations of kindness, 
patience, and a strict integrity to the public ; while we are ac- 
tuated by an honest desire to promote their health and welfare, 
self-respect requires us to say that we suffer much wrong at their 
hands. It is not to be disguised that men, occupying the high 
places of the land, ornaments to society, and even Physicians, 
lend themselves to the vile imposture of empiricism and quack- 
cry. Man, with all his acquirements, civilization and religion, 
is a credulous being; and this credulity is exhibited in a remark- 
able manner ui his use of secret remedies of €ven the most 



ridiculous pretensions. It is not surprising: tli^'^t ignorant persons 
should be duped and deceived by nostrums, freighted with re- 
commendations which assert a power to cure every ill flesh is 
heir to, and attempted to be sustained by certificates as ingenious 
as false; but it is surprising, and justly merits indignation, that 
men of sense and character should patronize the authors of this 
system of fraud — these sordid hucksters, who violate every prin- 
ciple of humanity — these mountebanks, who have stolen the 
garb of medicine in which to practice their diabolical arts — ^jug- 
glers in medicine, who, in defiance of decency, with a miser's 
unscrupulous lust after gain, under the disguise of falsehood 
and secrecy, deal in public credulity and trafiic in human life. 
These charlatans are our acknowledged and sometimes preferred 
competitors, who attain not unfrequently to boundless wealthy 
while the upright and well-informed Ph^^sician languishes in 
poverty and obscurity. 

It is the pride and privilege of the medical profession to ren- 
der gratuitous services to the Clergy and their families ; yet this 
influential, honored and holy class, whose mission it is to inves- 
tigate, cherish, and dispense a truth more glorious than that eman- 
ating from the lamp of science, are often so far forgetful of the dig- 
nity of their station, and of their obligations to society, as to sanc- 
tion by their approval, and encourage by their patronage, men who 
discard the patient pursuit of a profession and embark in a trafiic 
of deception, for the sole and sordid purpose of money-making, 
as must be obvious, upon mature reflection, to every candid and 
intelligent Minister of the Gospel. The press and the legislation 
of the country contribute to the advancement of quackery, and 
invest it with a false consequence. To grant patents for secret 
remedies is a palpable prostitution of the powers of legislation. 
It is the duty of the public to appreciate and patronize medical 
talent and worth, wherever found ; and when the profession 
shall clearly present these qualifications, and manifest their own 
appreciation of moral worth and ability, we may then expect 
public confidence and respect, and not till then. We must not 
tolerate those who are so unmindful of the distinction the medi- 
cal badge confers, as to sully it by unprofessional conduct ; nor 
must we countenance secret compounds of high-sounding claims, 
though they come to us endorsed by the dignitaries of the land, 
and recommended as possessing powers to establish the bloom 



ot* health upon the ravages of every form of disease. There are 
articles of acknowledged efficacy, prepared by apothecaries and 
others, whose ingredients are known ; they are useful and con- 
venient to the profession, and form exceptions to this just pro- 
scription of rank and ridiculous impostures. The American 
Medical Association has established a Board to analyze quack 
remedies and nostrums, now palmed upon the public, and publish 
the result of their examinations, with comments upon the na- 
ture and dangerous tendency of such remedies. Every Physi- 
cian must have been called on to rescue cases of disease from 
the aggravation and sometimes dangerous modifications pro- 
duced by their use. If the Board shall succeed in its Herculean 
task, and deprive these nostrums, now fillins^ and pillaging the 
land like swarms of locusts, of their chief charm and power — 
secrecy — it will have conferred a benefit upon society, as well as 
the medical profession, and the public will be amazed at the ex- 
tent to which they have been humbugged. The medical pro- 
fession have been contending for years with a species of impo- 
sition at once inhuman and piratical — the adulteration of drugs 
and medicines by unprincipled manufacturers, who have flooded 
our country with spurious and inert articles, thus blunting the 
very weapons with which we encounter disease, disappoint- 
ing the just expectations of the Physician, and blighting the dear, 
est hopes of his patient. I am happy to be able to say that this 
disgraceful trafiic has been checked, if not entirely broken up. 
Dr. Edwards, for his able and patriotic agency in procuring the 
proper legislation on this subject, and Dr. Bailey, for his effi- 
ciency and independence in giving practical effect to that legisla- 
tion, deserve from the country and profession lasting honor and 
gratitude. There is, however, to some extent, a home adultera- 
ation, and it is dilTicult to reach the perpetrators of this'fraud by 
law, but the vigilance of the profession will deter them from pro- 
secuting this disgraceful scheme. They will find it as ruinous 
to their interest as it is destructive to their character. And the 
dealer in drugs who may be detected in this infamous proceed- 
ing, will be published and branded as an impostor; and thus 
disappointed in his speculation and deprived of the power to 
deceive and injure, he will abandon his inhuman vocation. 
And while the national legislature has properly consigned adult- 
erated drugs to destruction, ouffht not North Carolina to forbid. 



by a legislative act, the sale of secret compounds within her 
limits, and to require the authors of the whole tribe of nostrums, 
under proper penalties, to liave the name and proportions of the 
articles of which they are composed, to be written out on the 
label in plain, vernacular English? While the Physician, who 
exposes the name and nature of his remedial agents to public 
view — who unsheaths and exhibits his weapons — cheerfully 
pays a tax for the privilege of practising his profession — shall 
the stealing trickster, who envelopes his nostrums in profound 
secrecy, be permitted to pursue unheeded his course of craft and 
treachery; and the Legislature, by its silence, confer upon him 
immunities denied to the regular practitioner? Judicious regu- 
lations exist on this subject in some of the States of the Union. 
- Permit me to allude to a few of the extravas^ant appendages 
of the medical profession — Homoepathy and Hydropathy — sys- 
tems containing some truth, though largely diluted with error. 
The inappreciable doses of Homoepathy is a pretty apt illustra- 
tion of the expectant plan of treating disease, and operate like 
doses of confidence, which are often of signal advantage. Who 
would at this day renounce cold water as a Therupeutic agent? 
Yet how vain the attempt to invest it with the virtues of a pana- 
cea — vainer still the attempt to dignify Hydropathy with the 
appellation of science ! Heat and Steam are also valuable agents, 
but admit not of that universal application in the practice af 
medicine, which is claimed for them by the misguided and fa- 
natical Thompsonian. 

I turn now, with pleasure, to the consideration of a more 
pleasing and useful subject. One of the highest objects of our 
Society is to ascertain the true nature and treatment of disease, 
as it occurs among us. However highly we may estimate the 
observation and experience of Physicians in foreign countries— 
however much we may prize the learning, research, and varied 
information which comes to us from native Physicians, whose 
talents, ability, and integrity adorn our profession — and, how- 
ever useful and indispensable all this knowledge may be, yet 
there is a local knowledge of disease which every Physician 
must acquire for himself — a modification of disease, which ac- 
curate observation at the bedside alone can teach him. Habits 
of life — age — condition in society — sex — peculiarity of consti- 
tutiou — seasons — epidemic influences — and particularly climate^ 



10 

are some of the circumstances which produce such modifica- 
tions, as to occasion in works of the highest authority, in regard 
to symptoms and treatment, a discrepancy of opinion, a dissimi- 
larity of views, constituting a fruitful source of confusion and 
medical skepticism. That we may have clear and satisfactory 
views of the correct treatment of diseases, peculiar to the diver- 
sified climate in which we live, we must learn then- true char- 
acter hy our own observation as well as by the teachings of the 
books. This study and observation of disease, with every at- 
tending and modifying circumstance, as well in relation to its 
theory as its practice, should be embodied and reported to this 
Society; that we may thus establish a standard of ripeped opin- 
ion and experience for our guidance and instruction in the treat- 
ment of disease, as it occurs in our several locations. To pro- 
mote this object, let every Physician keep a note-book, and reg. 
[ister his cases. This is a drudgery, but nevertheless a duty, 
and every Physician ought to perform it. He will then be fur- 
nished with important and practical information. Patient and 
correct observation, though humble and unpretending in its 
character — though deficient in the power to charm like the dis- 
covery of a new theory, which inventive genius weaves into a 
plausible and beautiful web— will stand out as a beacon light to 
direct the practitioner safely in his course, whilst the most inge- 
nious speculations are forgotten, or only remembeted as brilliant 
fancies. Extending the plan of forming an accurate acquam- 
tance with the diseases of the South, Dr. Fenner, of INew Or- 
leans, proposes to publish an Annual Volume, devoted to the ad- 
vancement of Medical Knowledge in the Southern States. If 
the plan of the "Southern Medical Reports" shall be fully car- 
ried out and properly patronized, it will collect and present in a 
durable form the experience and observations of the Physicians 
of the South, and will exert a more decided and salutary influ- 
ence in promoting medical education and forming the medical 
history of our own region than the Establishment of a Medical 
College. 

The accounts of the Meteorology, Medical Topography, and 
prevailing diseases of the year, with reports of important cases 
from all parts of the Southern country— an annual expression 
of medical opinion upon the diseases of the South, with an ex- 
position of their true character and proper treatment, can but 



11 

prove hio^hly interesting and instructive to the profession. The 
plan and objects of this work commend it to the patronage and 
support especially of every Southern Physi^-:ian. And as the 
accomplished Editor is a native son of Nonh Carolina, will we 
not feel a just pride and si.:cere pleasure m extending to him 
every encouragement, and in putting forth our best exertions to 
promote the success of his noble enterprise? 

It is not to be expected that I shall review and discuss the 
various recommendations of ihe American Medical x\ssociation. 
They are all entitled to our highest consideration ; and we 
should manifest our admiration of them by rendering a cheer- 
ful obedience to their important requirements. 

The transactions of the Association present much useful and 
valuable information. It is a volume of which every xAmerican 
Physician must feel proud. It is a rich contribution to medical 
science, and exhibits in pleasing relief the progress and digni- 
ty of our profession. 

I sh:dl purposely abstain from making many specific recom= 
mendations. I leave their adoption, as well as the cirrangement 
of the order and nature of our duties, to the wisdom and pleas- 
ure of the Society. Permit me, however, to call your attention 
to a few particulars in which we must all feel a deep interest. 
It is the very foundation stone for improving medical character, 
and imparting hig:her respectability and more extended useful- 
ness to the profession, that we should require of those who enter 
our offices to study medicine, to furnish evidence of a sufficient 
geneial education and of good moral character. From a strict 
observance of this rule, with an honest determination on the 
part of the practitioner to impart the fullest office iiistruction to 
his students, and to impress upon ihrm the n.ojal dignity of the 
mission to heal the sick — that it requires, not only that the head 
should be clear, but that the heart should be right — the standard 
of medical education v/ill be elevated, and inestimable advanta- 
ges will accrue to the profession. Additional efficacy will be 
imparted to this rule by lengthening the peiiod for the delivery 
of the lectures in all our Medical Colleges, thereby affording time 
for study and profitable attendance on well-conducted institu- 
tions for the reception and treatment of the sick. It is necessary 
to the success of the plan, that there should be a union and co- 
operation of all the M^^lical Colleges of the country. There 



12 

is too iiiuch matter crowded upon the medical classes in a term- 
much too short to study, digest, and retain the knowledge and 
facts which are taught with signal ability. If the present ar- 
rangement for public medical instruction is objectionable — if it 
be true — and candor compels me to admit that it is to a great 
extent — that the Doctorate is too cheap and of too easy attain- 
ment — the fault is not alone chargeable to the Colleges, but is 
also found to lie at the door of the practitioner, who receiv^es, 
without proper discrimination, the Student into his office, and 
fails in his duty to prepare him for attendance upon the lectures. 

The American Medical Association recommend, as the only 
practicable check on the too general right to practice, conferred 
by the diploma, that each Legislature shall establish an Examin- 
ing Board of disinterested Physicians, whose certificate shall 
confer the privilege of entering upon the practice, regardless, of 
the diploma. 

This plan Avould work no injury to the worthy and well 
qualified graduate, but would exclude the deficient. This sys- 
tem is in operation in the Army and Navy, and has been emi- 
nently successful in establishing a high order of professional 
acquirement in their Surgeons and Physicians ; and wherever 
introduced it has produced the same gratifying results. There 
is a strong impression on the mind of the profession in favor of 
its adoption in this counti}^ Whether we shall ask any action 
from the Legislature on this subject, I leave to you to determine. 

The popular and indigenous remedies of the State merit the 
care and attention of the Society. 

I recommend that the Legislature be memorialized by a com- 
mittee of your appointment, to pass a law which shall compel 
the registration of the marriages, births, and deaths. This law, 
once in operation, would furnish a fund of statistical informa- 
tion, important in a civil and political point of view, and useful 
to the legal as well as the medical profession. It is a reproach 
to any State to be without registration laws, which lead ulti- 
mately to the adoption of sanitary measures, now claiming an 
interest and attention, which the preservation of public health 
and the prolongation of human life must sooner or later com- 
mand. There is a means of improvement which the Legisla- 
ture ought by law to confer upon the Physicians of the State — 
the right to dissect the bodies of executed criminals, and those 



I'' 



o 



who die in iiistitulions of public charity. Unless friends or re- 
lations claim the bodies for burial, they should be delivered uj\ 
oil demand, to any Physician, for the purposes of dissection, 
preparation, or experiment. 

Allied to this subject, and one of vital import to the medical 
profession and to the public, is the privilege of making post 
mortem examinations of the bodies of our patients. This pro. 
ceeding the public invests with a species of horror. Friends 
regard it as a heartless liberty with the remains of the honored 
dead — as a violation of the sacred immunities of sorrow — as an 
invasion of the rights of affection. These impressions are natur- 
al — they command our sympathy and respect, but they spring 
from bosoms wruna-with an aguish, not from the convictions of a 
calm and undisturbed reason. There is a false delicacy on this 
subject, which we should seek to correct, by kind remonstrance 
and conciliatory appeals. We should familiarize the public 
mind Avith the necessity and importance of such inspections; we 
must impress upon it the truth that they involve no indignity 
to the dead — no disrespect, but a high and positive duty to the 
living. The public do not realize the fact, that, without these 
opportunities, the science of medicine would now be slumber- 
ing in its infancy ; nor do they reflect that these investigations 
increase our knowlec)o;e of disease and qualify us for its more 
enlightened and successful treatment. These things are palpa- 
ble to us, and we ought to persevere in our efforts to render this 
source of improvement accessible to the profession. 

I would call, especiall}^ upon the younger members of the 
profession, to come up to the work of reform and advancement. 
Upon them chiefly rests our hopes. Ti.ey have the time — the 
advantages of the recent improvements and discoveries in the 
science of medicine. Whatever of aid those of us who have 
grown grey and dim of vision can render, will be cheerfully 
contributed. While we will endeavor to* shed the light, beam- 
ing from the lamp of experience, upon the path of medicine, the 
young and rising must illuminate that path with the Drum- 
mond-light of learning. 

I now bespeak your kind indulgence for the many imperfec- 
tions of this hasty sketch. My apology must be, frequent in- 
terruptions, and especially my utter disuse and want of taste in 
the arts of composition. Accept my sincere acknowledgement^^ 



14 

for the honor you have conferred upon me of presiding over the 
deliberations of the first Medical Society of my native State. 
I will cherish it as one of the proudest recollections of my life. 
Here, on thisinterestinof occasion, let us pledge ourselves to each 
other upon the altar of immutable brotherhood, to accomplish 
whatever our hearts and hands find to do — to adorn and unite 
the medical profession — to promote its true glory — to brighten 
the pasfeof its history — to record its triumphs, and to contribute 
to the fulfilment of its high and holy mission to mankind.